On “anti-science” again

There’s something about the prefix “anti” that provokes all too many people, even some who consider themselves “skeptics,” to clutch at their pearls and feel faint. Antivaccine? Oh, no, you can’t say that! They’re not “antivaccine”? Who could be so nutty as to be “antivaccine”? Even members of the antivaccine movement don’t like the term because even they realize that to be antivaccine is akin to being “anti” Mom, apple pie, and America. So they come up with the defense that they are not “antivaccine” but rather “pro-safe vaccine.” They’ll come up with silly analogies about how being for safer cars doesn’t make one “anti-car.” It’s a silly analogy because it doesn’t fit. People who are pro-car safety still buy and use cars. People who are antivaccine will never, under any circumstances, vaccinate their children. Often, in order not to admit they are antivaccine, they’ll say they would vaccinate “if only.” After the “if only” will almost always follow safety standards that are, intentionally or unintentionally, impossible to meet, such as absolute guarantees of safety. As a result, if you try to pin an antivaccinationist down about what vaccines she considers safe and would use on her child, you’ll never get a straight answer. Instead, you’ll get excuses and the aforementioned impossible standards. I’ve written about these concepts before; so I won’t belabor the point (at least not more than I usually do).

The antivaccine movement is a subcategory of a larger movement, however. For want of a better word, let’s term it “anti-science.” It’s an imperfect term for people who reject well-established science. To get a flavor of what being “anti-science” means, take a look at people who reject evolution, reject anthropogenic global warming, reject vaccines, and reject scientific medicine in favor of quackery. I’ve written on many occasions about some of the common factors that tie such beliefs together, as have many others. So why bring it up again? First off, it’s in the news again, based on this news story about the recent meeting of the American Association for the Advancement of Science:

Most scientists, on achieving high office, keep their public remarks to the bland and reassuring. Last week Nina Fedoroff, the president of the American Association for the Advancement of Science (AAAS), broke ranks in a spectacular manner.

She confessed that she was now “scared to death” by the anti-science movement that was spreading, uncontrolled, across the US and the rest of the western world.

“We are sliding back into a dark era,” she said. “And there seems little we can do about it. I am profoundly depressed at just how difficult it has become merely to get a realistic conversation started on issues such as climate change or genetically modified organisms.”

As have I. So, because it’s in the news again and because I haven’t written about it in a while, I figured, what the heck? Once more into the breach, particularly given that I’ve come across a couple of rather ticked off bloggers who really, really don’t like the term “anti-science.” These include Jack Stilgoe, who wrote a post entitled Anti-anti-science. It’s a title I find rather ironic, given that those of us who combat the anti-vaccine movement sometimes refer to ourselves as “anti-anti-vax.” Maybe Stilgoe is “anti-anti-science” as well. Not really, because he’s really annoyed at Federoff’s comment. So is Marya Zilberberg, who lambastes such language as The taxonomic laziness of “anti.” Both take a reasonable point and then go beyond it in such a way that it reveals how little they know about the anti-science movement, of which creationists, anti-vaccinationists, and AGW “skeptics” are but a part.

My over-riding impression is that ‘anti-science’ is a term that is imaginary and unhelpful. It describes almost nobody and it gets us nowhere. Climate deniers are not anti-science, they are anti- a political view that considers environmental protection as important. Creationists, too, have moral objections to the implications of an evolutionary worldview (John Evans is very good on this). In both cases, these groups use science arguments as their vehicle because they are more sophisticated sociologists of science than the scientists themselves. Where scientists see their evidence as a solid stage on which the public drama of policy can take place, creationists, denialists, anti-vaccinationists and others see a precariously balanced house of cards. Yes, they are stupid and wrong, but calling them ‘anti-science’ doesn’t help. Hitting these people over the head with bigger and bigger science hammers will not win the argument, it will simply confirm their suspicions.

There’s no doubt that the word “anti-science” can be inflammatory, but it is far from imaginary. Stilgoe is confusing motivation with actions and, surprisingly, comes close to the truth without actually reaching it. When he points out that climate denialists are “anti- a political view that considers environmental protection important,” he is correct, but he doesn’t take that observation one step further to realize that it is that particular “anti,” which is a political/ideological view, that drives AGW “skeptics” in the first place to be anti-science! The same is true of those who reject evolution, where it is almost always fundamentalist religion that drives the rejection of science. Stilgoe notes that creationists reject evolution because of their religion and because they don’t like the implications of a worldview that includes evolution. This is largely correct. It’s also the reason they become anti-science in the first place.

The antivaccine movement is a little different, but much of it is fundamentally the same. Basically, there are two main varieties of antivaccine activists. The first kind blames vaccines for injuring their children, usually causing autism. Even though it is a scientifically discredited notion that vaccines cause autism, this first sort of antivaccinationist is at least somewhat understandable because humans are pattern-seeking creatures who are quick to confuse correlation with causation. The second kind of antivaccinationist rejects vaccines from a world view that is antiscience to the core, often rejecting modern medicine, sometimes even germ theory itself. I’ve catalogued so many examples of the latter kind of antivaccine activist on this blog over the last seven years that I can’t even come close to remembering them all.

Interestingly, Stilgoe also seems to admit that he might be considered “anti-science” by some:

One reason the term ‘anti-science’ raises my hackles is that I think the big beasts of science who use it might be talking about a group that includes me. We social scientists and policy folk have been known to ask difficult questions of science that have been interpreted as attacks.

Well, I suppose if Stilgoe’s into postmodernism I might suspect him of being anti-science. In fact, I view postmodernism as being at the root of a lot of anti-science views among some academics. After all, postmodernism seeks to diminish science to nothing more than just one among many competing narratives, all potentially equally valid. But let’s assume that Stilgoe isn’t a postmodernist, as I see no evidence that he is. Why does he think that being a social scientist leaves him open to spurious charges of being “anti-science”? One wonders what “difficult questions” he asks. Be that as it may, one suspects that Stilgoe is having trouble telling the difference between a critical examination of the scientific process and hostility to science itself. One is not “anti-science.” The other is. Stilgoe also reveals an astonishing apparent ignorance of how anti-science forces operate:

I find it worrying that, at a time when science enjoys astonishing privileges, political support and stable funding when so many other areas are in turmoil, scientists talk, as Fedoroff did, about it being ‘under attack’. Paul Nurse was guilty of this in his recent Horizon programme and John Beddington provided some thoughtless remarks about intolerance (see this post). Both men have said sensible things about science and policy, but their reasoned arguments are undone by the Manichean retreat to us-vs-them. In democratic societies, science is part of the conversation. Dissent, challenge and scepticism are inevitable. Science has to learn to talk about alternatives, to talk about possibilities, to talk about diverse, desirable and undesirable futures.

What planet is this guy living on? Stable funding? Not here, not now. The NIH budget, for instance, doesn’t keep up with biomedical inflation anymore, and funding rates haven’t been this bad in at least 20 years. Some of my more senior colleagues claim it hasn’t been this bad in 35 years. Funding for science, thanks to the 2008 economic meltdown and other factors that preceded it, hasn’t been so tenuous in a long time. There are a lot of us out there who wonder how much longer we can keep our labs funded.

As for “astonishing privileges,” whatever privileges science might enjoy have been, I would argue, more than earned. One wonders, though, why Stilgoe chooses that word, “privilege.” It seems to bother him, as if science doesn’t deserve it. It is also a bit of a non sequitur to argue that somehow this privilege is a reason that complaints that science is under attack are overblown or otherwise not credible. The two are not mutually exclusive, and there’s no doubt that science is under attack on many fronts and in different ways. Moneyed interests are clearly attacking climate science. Religious extremists are attacking evolution. And ideologues who reject modern medicine are attacking science-based medicine, even succeeding at infiltrating their viewpoint into what should be bastions of science-based medicine, our medical schools and academic medical centers.

Stilgoe’s also attacking a bit of a straw man. No one I’m aware of who opposes anti-science argues that science is the be-all and end-all. There is wide consensus that science is not the whole conversation. Particularly in areas where science interfaces with politics, science can only inform politics; it is the politicians who end up making policy, hopefully based on good science, but not infrequently that’s not the case.

Not too surprisingly, given my previous sparring with her, during which she criticized science-based medicine on more than one occasion, Marya Zilberberg is very impressed, very impressed indeed, with Stilgoe’s arguments, so much so that she dismisses the use of the term “anti-science” in terms of her two children fighting about who’s being more “mean.” At least, that’s how she introduces her paean to Stilgoe’s post.

I will concede one point. Zilberberg is correct that it is possible to be too promiscuous with the use of the term “anti-science.” It can be lazily applied and applied where it’s not appropriate. That is a temptation to be resisted. Unfortunately, she goes wrong in two ways. First, she falls for the fallacy of, “Why can’t we all just get along?” in which she doesn’t like the use of the word “anti-science” because it pisses off those who are anti-science. (Yes, that’s exactly what one of her main objections boils down to.) Her second objection is this:

At another level, such labels give rise to a deeply flawed impression that science is precise. Indeed, those who fling these labels tend to fall on the old refrain of “look, I am the first one to admit that scientific knowledge is fungible.” However, in the instances of current confrontations, they somehow cannot imagine that our current knowledge is incomplete and that further questions are not only legitimate, but are indeed a scientific imperative.

Little does Zilberberg know it, but this is exactly the sort of argument that those who are anti-science make, with one crucial distinction. Scientists understand that science is provisional, which is why it’s so difficult for them to come to a consensus on issues. When they do come to such a consensus, whether it be a theory (as in the theory of evolution or the theory of relativity) or a consensus that is not referred to as a theory (as in anthropogenic global warming), it is usually based on overwhelming evidence. Certainly that is true of the aforementioned theories and consensus, and it’s certainly true about the safety and efficacy of vaccines. What “antiscience” does is, as it is commonly described, to sow fear, uncertainty, and doubt about well-established science. We aren’t talking about science on the fringes, where there is considerable disagreement among scientists. Rather, those who are “antiscience” attack science that is about as well supported as anything in science can be.

Now that I read her post again, it occurs to me that there is a third area in which Zilberberg takes a germ of a reasonable point and then goes right off the cliff with it:

I realize that it is tiresome to have to argue that creationism is not science, that evolution is more than just a theory, that vaccines have saved millions of lives. But to write off these arguments as beneath us and to throw insults at each other only works in Washington, and look how well that has been going. But even more importantly, if we are going to answer such deeply pragmatic scientific questions of our time as “what are the full implications of GM salmon,” we cannot shroud ourselves in the “sacredness” of science. Science can only stay beautiful and true if it steers clear of being dogmatic. It is time to take this discourse out of the boxing ring of childish insults and back into the civic society where if belongs.

Once again, as she has done in the past, Zilberberg indulges her penchant for straw men. Those of us who argue against pseudoscience such as antivaccinationism and creationism obviously don’t consider it “beneath us.” If we did, we wouldn’t do it. Does anyone think that I, for instance, would have spent the last seven years of my life writing Orac-ian deconstructions of pseudoscience multiple times a week if I thought that doing so was “beneath me.” No! We defend science against antiscience because we’re passionate about science and want to promote and defend good science.

One can’t help but note that both Stilgoe and Zilberberg–is that anything like Zager and Evans?–are also very indignant about opponents of genetically modified organisms being lumped in with anti-science. Indeed, one wonders whether that is one of the main things that bugs them about the word. While it is true that there can be legitimate criticisms of GMO (and, indeed, it was his relentless cheerleading for GMO that lowered my estimation of Michael Specter’s book on denialism), there are an awful lot of anti-GMO attacks that can be best described as, well, anti-scientific. Such attacks focus on GMOs being somehow “unnatural” and therefore dangerous, an affront against nature, rather than focusing on how GMOs are used, the latter of which, depending on the specific criticism, can be defensible.

Both Stilgoe and Zilberberg also seem to base their criticism of the term “antiscience” on the premise that, as Martin Robbin points out, “all groups engaged in controversial scientific issues are all there because they care about the truth of the issue.” They don’t. In fact, part of what makes those described as “anti science” antiscience is that they think they already know the truth of the issue and that what science says about it is not that truth! Some of these people genuinely believe that science supports them; they are profoundly misguided by not antiscience per se. Others think they know the truth and don’t care what science says. These people can be fairly characterized as “antiscience” because they not only reject what science says but how science comes to know what it knows. Let’s just put it this way: If there’s no amount of scientific evidence that will persuade a person to change his mind, then that person has abandoned science to the point where one might accurately refer to him as “antiscience.”

Basically, Stilgoe and Zilberberg almost make a good point but ruin it through overreach and self-righteousness. The overreach is that neither of them seem to believe that there is such a thing as antiscience. About this there is no other way to put it:
they are, quite simply wrong, as some of Stilgoe’s commenters demonstrated and as I could demonstrate by burying them in antiscience quotes. Instead I’ll just point them to a an amazing antiscience video by Mike Adams in which he basically characterizes science as evil (complete, of course, with lots of references to Hitler). As evidence, he refers to modern medicine, vaccines, GMOs, pesticides, and many other things. He also claims that science is what allows us to commit genocide. It’s a version of the already hysterical message that Ben Stein promoted in his anti-evolution documentary Expelled!, which featured Stein visiting the ruins of Nazi death camps and using them as evidence of where science leads. Mike Adams, however, cranks up the hysteria to 11.

That looks pretty antiscience to me.

The self-righteousness comes when Stilgoe and Zilber lecture those of us out in the trenches for using the term “antiscience,” seemingly because they value civility Ã¼ber alles and find it horrible–horrible, I tell you!–that anyone would actually call it as he sees it. Of course, as was evident in the quote I cited above, that doesn’t stop Stilgoe, for instance, from characterizing creationists, denialists, antivaccinationists as not just wrong but “stupid and wrong,” which to me seems a bit more insulting than referring to them as just “anti science.” But then that’s just me. Stilgoe’s also–dare I say it?–wrong. If there’s one thing I’ve learned about various antiscience activists that I’ve encountered over the last seven or eight years, most of them are not stupid. In many, if not most, cases, they’re quite the contrary. In fact, right here I can’t help but point out that the stupid antiscience activists are the easy ones to deal with because they’re stupid. The more intelligent an antiscience activist is, the more able he or she is to cherry pick data to construct arguments that sound more plausible, do a Gish gallop defending nonsense, and just in general to be more of a pain to refute. Also, I can’t help but point out that Stilgoe’s willingness to label such people as “stupid” rather belies his invocation of civility as a reason not to be using the term “antiscience.” It suggests that he does’t mind incivility but just doesn’t like one particular variety of what he perceives as incivility, namely calling someone “antiscience.”

In actuality, there are at least two forms of science rejectionism, one that can be considered antiscience and one not as much. First, there’s the form of science rejectionism that results from science coming into conflict with deeply held ideological, political, or religious beliefs. People holding such views tend to reject specific findings of science that they don’t like but not science itself. They are thus usually (but not always) not antiscience per se, which is why I prefer the term “denialist” to describe them. AGW denialists are a good example of this group. Then there is a group that rejects the very core of science itself; i.e., the methods, peer review, the standards of evidence itself. Mike Adams is certainly just such a person.

So are a significant fraction of antivaccinationists. All you have to do is lurk a while on various antivaccine discussion groups to see a profound antipathy towards the scientific method itself in favor of anecdotal evidence and “mommy instinct.” Jenny McCarthy herself is an excellent example of this. She once said “Evan [her son] is my science” on The Oprah Winfrey Show and scoffed at all the science showing that vaccines do not cause autism because, well, she’s seen it herself. Indeed, the same hostility towards the scientific method and the fruits of that method that form the basis of scientific medicine is evident in huge swaths of the “alternative medicine” movement, where anecdote is valued over controlled studies, correlation is confused with causation even after science fails to find evidence of causation, and “personal experience” matters more than clinical trials or basic science. There is also considerable overlap between these two forms of science rejectionism. For example not all denialists are antiscience (just anti-specific science), although I’m hard pressed to think of examples of people who are anti science but not denialists. Being anti science usually leads to denialism in multiple areas, a phenomenon known as crank magnetism.

To the extent that Zilberberg and Stilgoe caution us as science communicators not to be too footloose and fancy free throwing around the term “antiscience,” they make a reasonable point. We as defenders of science need to be careful not to use the term inappropriately, lest it lose its meaning and become just an insult. Unfortunately, Stilgoe and Zilberberg couldn’t leave it at that. On the other hand, we should not shy away from using the term when it’s appropriate, because it is an excellent shorthand to describe a phenomenon that is, unfortunately, a serious problem. Just because the word offends some people ostensibly on “our side” is not a reason to abandon the use of such a useful and descriptive word.

Indeed, those who fling these labels tend to fall on the old refrain of “look, I am the first one to admit that scientific knowledge is fungible.”

“fungible”?

That word has no meaning in that sentence. “Fungible” means that the good in question can be substituted freely. For instance, there are some algorithms that can be solved by a computer calculating for six minutes, but cannot be solved by two computers working together for three minutes each; the calculation time is not fungible. If “fungible” is indeed the word she used, methinks she mistook it for a fancier synonym of “fallible”.

I’ve become far too familiar with one branch of this phenomenon, because I’ve been engaging in hand-to-hand combat with global warming denialists in the comments sections on the Wretched Hive. It is exactly as you describe.

The constant calls for civility rather get to me. I hadn’t noticed them so much in the anti-science medical online discussions. (Though I have noticed a matching set of calls for people to use ‘real’ names.) But they’re relentless on climate discussions – funnily enough, I’ve only ever been called filthy names in those selfsame venues. Some civility!

I’ve now come to regard such exhortations as good reason to review remarks from such people with more care.

He seems to be missing that there’s a big difference between legitimate debate and what can be called anti-science. When Paul Offit voted against bring back the smallpox vaccine, that didn’t make him anti-vaccine. I’m as pro-GMO as they come, but I still think some GE applications, like producing ‘pharma-crops’ out of wind pollinated staple cereals, are horrible ideas. Disputing the structure of a particular phylogeny does not make one anti-evolution. There are legitimate debates to be hand in any area, but those are different than rejecting the ideals of science (and using various quack tactics) to promote your cause. Regardless of the politeness of such a phrase, what is that if not anti-science?

After delving into alt med, I can’t think of a better word: ‘anti-science’ perfectly describes the agenda. They reject the consensus – work done over decades by serious researchers- because *none* of it is *independent*: it is tainted by pharma and government money; it reflects COIs; universities are “bought and paid for” by corrupt entities. They ridicule momentous advances against infectious disease, HIV/AIDS, and SMI: a stream of invective is spewn daily by advocates.

Data is replaced by anecdote: (just over the past few days)-
Adams writes about a doctor reversing her husband’s Alzheimer’s through the adminstration of coconut oil. Null reveals how a doctor sought him out to reverse her MS because of his previous success with that illness and Alzheimer’s. Meanwhile, amateur speculation into immunology and toxicology is rampant @ AoA as they chime in their ideas about the DSM-5.

It’s about faith and religious zeal more than observation and replication.

Orac uses poor reasoning in this article. He’s trying to pigeon hole a large group of people so he can then douse them with strawman arguments and ad hominem attacks.

Basically, there are two main varieties of antivaccine activists. The first kind blames vaccines for injuring their children, usually causing autism.

The second kind of antivaccinationist rejects vaccines from a world view that is antiscience to the core, often rejecting modern medicine, sometimes even germ theory itself.

Is science a worldview now? I thought science was a method. When did scientific technology become a philosophical worldview? When did it proclaim itself the THE worldview, the ONLY worldview, and the absolute CORRECT worldview.How did it do this? Who deemed it so? How does god fit into this paradigm? Is there any logically consistent room?

And here’s the stawman basis. When you act as if you speak for science you are speaking from this philosophical worldview not the method of science itself.

Medicine is NOT science itself.
Vaccines are NOT science.
GMO’s are NOT science
Bombs are NOT science.

They are technologies. To the skeptic, if one does not agree with the philosophical use of technology then one is rejecting science itself. Perhaps they are unconsciously rejecting metaphysical naturalism, scientism, or utopian social darwinism. Not necessarily the scientific method.

If you steal fire(the first technology) from Zeus and use it how you see fit with your own ideas, then you are bound to get punished. Right, Prometheus?

But of course in your worldview,there is no Zeus or other gods before you. There is only the egotistical, fallible human mind that you worship.

âWhere were you when I laid the foundation of the earth?
Tell Me, if you have understanding,” Job 38:4

The argument is over ethics and morality. Not the scientific method. Your argument is over epistemology. That’s why it will never end.

Climate deniers are not anti-science, they are anti- a political view that considers environmental protection as important.

Nonsense! Climate deniers deny that the climate is warming, or at least that human activity is a primary cause. Certainly there are such people – who deny that global warming is a problem, even if they accept that it’s occurring. But those are not the people typically described as climate deniers.

Stilgoe seems to want to redefine climate denial so it will better fit his thesis. He does essentially the same thing with evolution denial, though not as explicitly.

It definitely goes beyond “anti-consensus” even though that’s what they would have you believe – that they have some kind of legitimate position, but their absolute fixation of vaccines is what does them in on this front.

Everything else from them is a smokescreen – they are anti-vaccine to the core.

Climate deniers are not anti-science, they are anti- a political view that considers environmental protection as important.

Being for or against something based on political views, regardless of the evidence, is anti science. Forming views before youâve seen the evidence, and continuing to hold them regardless of evidence is the definition of anti science.

Calling someone âanti-scienceâ is not an insult as Zilberberg says, it is simply describing what they do and what they are.

They masquerade their pernicious woo as *new* science, declaring themselves harbingers of “Paradigm Shift”: the old, compromised SBM shall be cast upon the dust heap of history and will be replaced by more spiritually-inclined innovators who follow in the footsteps of Pauling, Duesberg and Wakefield! People will research their own nutritional treatments for serious illness and postulate nouveau theories of vaccine-induced autism and chronic illness on a weekly basis! And like any cargo-cult, they carefully appropriate the verbal trappings of science to tart up their fantasy-based posturings. As one frequently remarks,” I’ll put this in lay language.”

Boy, do we ever need to teach critical thinking skills in schools, now more than ever!

There’s a seed of a good start in most of these positions, as Orac and others have mentioned. Denice brings up the tainted research angle– it is legitimately good for people to read research with a skeptical eye on funding sources and other conflicts of interest! But it can’t be the sum total of one’s thought process, to dismiss the content as bad JUST because of the funding source. What was the experimental design? How well did it control for confounding variables? Did they analyse the results with an appropriate statistical test for their experimental design? Was their methodology appropriate to the experiment, was their experiment a sufficiently rigorous test of their hypothesis, how likely is their hypothesis to be plausible based upon prior probability, these are just SOME of the questions they should be asking themselves as they read a study, not just who funded it or whether it supports their pet belief!

I think every child, from the earliest age, should be taught about confirmation bias. Dick Feynman’s simple, elegant statement of that is how I aspire to do my thinking, and what we should be aspiring to teach all students– “Try not to fool yourself, and you are the easiest person to fool.”

Hilariously enough, while the woo-meisters question virtually every advance in SBM/ Psychology ( e.g. HIV doesn’t exist/ is harmless, chemotherapy doesn’t work, there are no pharmacological treatments for SMI/ SMI doesn’t exist, no genetic/ perinatal evidence for ASDs, etc) because of institutionally *tainted* and *corrupt* research, they accept the work of one AJW on faith: no problem there.

Why is it so hard for you to understand that a real scientist would support judicious use of all medications and medical interventions?

Not the same dose for everyone or the case same surgery for everyone or the same protocol for everyone.

I don’t see how tailoring an individualized dosing regimen/protocol represents ‘real’ science, in the absence of any evidence that failing to do so results in adverse outcomes and/or doing so leads to improved outcomes.

Consider ibuprofen–when you prescribe it to address fever or inflammation, do you really craft a specific, individualized dosing regimen for each and every patient?

Or do you simply prescribe it be taken every 6 to 8 hours according to the previously established dose per weight schedule (50 mg’s for patients weighing 12 to 17 pounds, 75mgs for patients weighing 18 to 23 lbs, 100 mgs for patients weighing 24 to 35 lbs… etc.)?

What’s terrifying to me is that anti-science (whether that term is appropriate or not) does seem to be gaining a significant foothold in the United States, and many people–including politicians–are somehow proud of the fact that they don’t pay any attention to those elite scientists in their ivory towers who, you know, KNOW stuff. And have liberal commie advanced degrees.

I think one underlying issue is that the uneducated have decided to rise up and declare that their voices and worldviews have just as much weight–if not MORE–than educated scientists. At a certain point, people started taking it personally, and anti-science became a matter of pride. Science itself is not a worldview; it’s a tool by which we observe the world.

My wife studied rhetorical theory, and she’s convinced that scientists are losing the war of knowledge in the USA because they’re unwilling to get “down in the mud” with the anti-science crowd. I don’t think scientists should have to–the data should stand on its own–but the last decade or so has made it pretty clear that people don’t want to learn, and they don’t want accuracy. They want their own point of view and their own irrational behavior validated. And, very often, science contradicts those things.

I prescribe ibuprofen for specific indications with doses specific to a patient’s weight and age. I also consider family history of medication allergies and sensitivities and the individual’s reaction to previous medicines.

In pediatrics, we do this with every other medication except vaccines!

Thank you, JG. It’s good to find an ally in my occasionally illogical discussions with the anti-science crowd here.

auggie, fire’s not a technology. It is a natural phenomenon. The artificial creation of fire is a technology, based on the scientific theory of flamability. Medicine itself is not a technology; it’s a practical application of science.

In my experience, any time a person responds to a statement of scientific fact, like “the earth is approximately four and a half billion years old,” with some variation of, “Why do you have to be so rude?” “Why can’t you just accept that other people feel differently?” “Why is your mind so closed, can’t you look at the other side?” the person making those responses is *always* hard-core anti-science.

Science is not a matter of personal opinion. If I say I like chocolate cake, and somebody says, “well you’re just wrong,” that’s rude. If I say carbon dioxide is an element, and a bunch of chemists jump on me for it, they may shoot me down rudely or gently and politely, but they are still right to shoot me down. Carbon dioxide is not chocolate cake– and it is also not an element.

Dr. Gordon: Your example of ibuprofen is extremely simplistic. Vaccines are not a medication in the same sense as ibuprofen or an antibiotic. This only supports my experience in reading your previous post here and at other locations. The conclusion would be that you paid very little attention in you pharmacy and physiology classes. Even a medical student drive a truck through the holes in this comparison.

In pediatrics, we do this with every other medication except vaccines!

Oh, really? So you’re saying that pediatricians never consider the patient or their family history before giving a vaccine to a child? Citations, please.

You know, it would be really nice if, when vaccines are developed, the manufacturer did dose-finding and -optimization trials in children as part of their approval process to ensure that they are both effective and safe. It would also be nice if they were to list contraindications (e.g., history of allergic reaction, hepatic/renal insufficiency, etc.) in the vaccine inserts. Oh, that’s right. They do.

Dr. Gordon: Ibuprofen is eliminated by the kidneys and there are known differences in rates of elimination based on patient weight, therefore differences in dosing to deal with this. Vaccines, as I pray you know, since you have an MD and like to put FAAP after your name, doses not function by the same mechanism as ibuprofen nor is eliminated like ibuprofen. I hope this is not a reflection of the way you practice medicine … if so I worry even more for your patients than I have.

I prescribe ibuprofen for specific indications with doses specific to a patient’s weight and age. I also consider family history of medication allergies and sensitivities and the individual’s reaction to previous medicines.

How does this not simply represent a one-sized-fits-all standard of care re: ibuprofen?

In pediatrics, we do this with every other medication except vaccines!

How does vaccine dosing differ than ibuprofen dosing, exactly? As far as I can see you’re administering ibuprofen in exactly the same manner that others are administrating vaccines.

Or do you really believe that the vaccine schedule isn’t informed by the patient’s age, that the pediatricians delivering the vaccines aren’t taking into consideration family history re: medication allergies and sensitivities or the individual’s reaction to previous vaccinations?

Thank you, JG. It’s good to find an ally in my occasionally illogical discussions with the anti-science crowd here.

I think you may want to revisit whether you’d consider me to be an ally. I agree that there is an anti-science crowd, but that would be the posters suggesting that vaccines cause ‘damage’ as they variously define it, that the percieved increased frequency of autism results from something other than increased surveillance/diagnostic substitution, that vaccines are problematically full of “toxins”, that the current schedule for childhood vaccines constitutes ‘too many too soon” and could possibly overwhelm a healthy child’s immune system, or…

Well, I’m sure you get the picture.

BTW, I note that you didn’t answer the initial point I raised: o you believe that ‘real science’ argues we should be tailoring individualized vaccine dosing schedules in the absence of any credible evidence that failing to do so results in adverse outcomes, and/or doing so would lead to improved outcomes?

To further clarify, very simply, a real scientist would not give the same dose of ibuprofen to an 18 pound baby as he or she would give to 180 pound adult.

Nor would a scientist give the same polio vaccine to those two people.”

Not taht he wouldn’t give them the same polio vaccine–recall that 18 pound baby and 180 adult are receiving the same ibuprofen–but that he would tailor the schedule to account for the differance in weight and age. that’s done with polio vacines as well–you are aware that there are both childhood and adult schedules, I trust.

Of course, there’s still the question of why, in the absence of any evidence indicating that there’s a problem with doing so, the scientist must conclude a priori that adults and infants must be dosed differently.

@augustine
Rather than throwing around terms you don’t appear to know the definitions of, try coming up with examples of groups or people that don’t fit Orac’s characterization of anti-vaccinationists.
Just a tip.

I was tempted to reply to Dr Jay as well, but he’s getting such a scientific smack-down already I almost feel sorry for him.
However, I do have a very sincere question for you, Dr Jay:
From one FAAP to another, why do you actively promote yourself as a Fellow of the AAP when you have such disagreement with so many of that organization’s recommendations?

there’s still the question of why, in the absence of any evidence indicating that there’s a problem with doing so, the scientist must conclude a priori that adults and infants must be dosed differently

Because Dr. Jay, MD, WAANK, is, as lawyers say, “assuming facts not in evidence.” He’s also using a sorites (a form of syllogism where premises are elided because they’re assumed), and omitting the part about “We know that many medications’ dosages are weight-dependent, therefore…”

As a non-medical person, it isn’t immediately obvious to me that vaccines must be weight-dependent; I assume that what causes an immune response in a baby might also work just as well in an adult, but a medical person ought to know better.

That’s the thing about argumentation, doc, you have to account for all the steps in your chain of logic. Since I’m a technical writer, the analogy which leaps immediately to mind is a user manual for an access-controlled system which omits information on how to get user credentials and log in.

Most adults do not need polio vaccine because they were already vaccinated as children. But three groups of adults are at higher risk and should consider polio vaccination in the following situations:

So polio is not on an adult schedule. It is just for adults who are going to where there is a high number of polio cases, someone who works in a laboratory or someone who is working with persons with polio.

It also had a link to the adult schedule where polio is no where to be found.

In the future, Dr. Jay, you should actually read the sites you link to.

Now, perhaps, you can tell us how the DTaP and Tdap are different from each other.

Though it is interesting that you said “20 pounds” for a one year old child. That is a fairly small child. Though I suspect the reason there is only one MMR is that not many adults get it that vaccine, and they don’t need as much (yeah, try answering the question about the diphtheria, tetanus and pertussis vaccine, it might give you a hint).

You should really sign up for some Continuing Medical Education credits on vaccines and immunology taught by someone who can really answer your questions (a real immunologist, not a DAN! doctor).

It demonstrates that the question is recognized, and doses will be adjusted where necessary. If you believe it’s necessary to adjust doses in cases where the entire rest of the medical profession has concluded the evidence says otherwise, you’re going to need some actual data.

Your influence on this crowd is dramatic and discourages innovative thinking.
A real scientist–instead of a dogmatic anti-science zealot–would want to keep exploring options and alternatives with an open mind.

Your not a real scientist: You just play one on TV.

~~

#23 lilady

I can’t believe that the “real” Dr. Jay would be posting that.

Yes that was rather odd, considering he posted the following on the Amy Farrah Fowler thread just a few minutes later at 1:57PM..

#184 [“Say it ain’t so, Amy Farrah Fowler!” thread]

If I ran this site, I’d be embarrassed at the persistent ad hominem attacks and the low level of discourse.
Jay

@Cynical I prefer to work as best can from within the AAP rather than being completely on the outside. There’s obviously a lot that’s good about conventional modern medicine and pediatrics. And a lot of intelligent very well-meaning pediatricians.

Yes, I think that the AAP has been corrupted by formula company money but I haven’t lost hope that we could change this.

Dr. G. Buchwald and Dr. Boyd Haley are way smarter than everyone here, kind of like how Dr. Gerhard Gerlich understands physics and this disturbed “Orac” left-brained idiot does not.
Rosalind Harding: âThereâs no clear genetic test. Weâre going to have to let the fossil people answer this one

A real scientist–instead of a dogmatic anti-science zealot–would want to keep exploring options and alternatives with an open mind.

A real scientist would know that anecdotal observations of an unrandomized and uncontrolled population sample are not reliable data to make generalizations from. Especially when that sample is far too small to generate any meaningful or statistically significant conclusions.

lilady, you obviously don’t understand the intent of my original question-because you’re an idiot- so I’ll revise it: what specific symptoms of Hepatitis A disease necessitate or warrant a vaccination procedure?

I took a look, though I could only access the extracts, and you know what? Taking the patient into account, as well as family history, features quite prominently in the Red Book! So much for your claim that pediatricians never do that.

Now I am waiting for the advice that you can easily avoid HepA by simply not eating.

(Years ago I remember news reports were fairly common that a restaurant employee was found to be infected and people who had been to that particular establishment should get an immune globulin shot. One entire office area of a building I worked at had to get those shots because someone there came down with HepA, and they had been sharing a popcorn bowl. That doesn’t happen much anymore.)

lilady, thank-you for providing a “rationale” for a belief that hepatitis A disease merits a prohibitive vaccine. In actuality, Hepatitis A is a mild, self-limiting disease, resolving on its own with no treatment in 4-8 weeks. Most infections are subclinical, meaning that most people who get the disease never even know it because they never manifest symptoms. (Merck Manual, p 377) The journal Pediatrics agrees:
“Most HAV infections in young children are asymptomatic… Clinical hepatitis occurs in fewer than 10% of infected children.”
This disease is so mild that 90% of kids who get hepatitis A never even know it. Even the National Institutes of Health states that:
“Most people who have Hepatitis A get well on their own after a few weeks.” – NIH Manual

I have a comment in moderation, so let me try again: I think notdrew is arguing that having dark urine, fatigue, itching, loss of appetite, low-grade fever, nausea and vomiting, pale or clay-colored stools and yellow skin (jaundice) for 3 to 6 months is much less damaging than getting one of them evil vaccines. And if you happen to infect the elderly or immunocompromised along the way and kill a few of them, well, that’s just too bad.

lilady, you obviously don’t understand the intent of my original question-because you’re an idiot-

No, I don’t believe that is the reason. It is perhaps because you just said “what exactly is Hepatitis A?”.

Now if you had actually been more clear and said what symptoms make it worthwhile vaccinating for, then you would have been understood. Though the answer given to you by lilady and Stu would still be valid.

Unless you are one of those people who can take months off of work due to fatigue, loss of appetite, low-grade fever, nausea and vomiting. Many normal people would rather avoid that.

@lilady: Thank you for the compliment… just around, just busy and lurking — here and on that epic Jonas thread. Thingy made a lot of threads here just… well, boring. There’s only so much of the clinically insane one can take. Although I think notdrew is going to outdo Thingy in pure, unadulterated Dunning-Krueger.

Following the Gulf oil spill Dr. Terry Hazen, Berkley described DOE distinguished scientist, announced to the Washington Post that bacteria ate the oil and thus helped spread the idea that we have nothing to worry about when it comes to deep water oil spills …

According to Dr. Hazen his/their research provided

“the first data ever on microbial activity from a deepwater dispersed oil plume,” and the microbes’ speedy rate of degradation showed that the bacteria plays “a significant role in controlling the ultimate fates and consequences of deep-sea oil plumes in the Gulf of Mexico.”

What Dr. Hazen failed to disclose was a $500 million gift from BP to his lab. For a different look at this particular issue I recommend ‘Vulture’s Picnic’ by Greg Palast. (In the spirit of full disclosure, I have no connection to Mr. Palast and don’t really care whether you beg, buy or borrow the book.)

Point being: So-called scientists have, for many years now, been engaged in shooting the authority of science in its metaphorical foot. From black lung to tobacco and thalidomide to oil, ‘scientific’ opinion has been shown to be malleable when money is properly applied.

Even though I fear the consequences of the wrong-headed opinions of climate change deniers et.al., I dislike smug demonizing. When the ‘scientific community’ ceases to produce and lionize the Dr. Hazens of the world then it might find it has a better platform from which to persuade the public at large.

jay Gordon, MD, FAAP @20 : “Your not a real scientist: You just play one on TV.”

Two people wondered if that was the real Dr. Gordon, especially since he’s on the other thread tut-tutting about what a bad lot of commenters we are. Â By my count, what appears to be the real Dr. Gordon has commented five times on this post after comment #20, and has not offered any comment at all about that comment.

I have reached a personal conclusion as to who wrote comment #20, and my opinion of Dr. Gordon has dropped a bit further. It is asymptotically approaching zero, so it didn’t drop far.

@LW I’m not quite sure what you’re talking about but if you’re commenting on the the phrase“”Your not a real scientist: You just play one on TV.” it’s a play on words on the oft-used comedic phrase: “I’m not a real doctor but I play one on TV.” The tone was somewhat jocular and an attempt at role reversal because everyone attacks the so-called anti-vax crowd as anti-science. You see, I was turning that around, again, for comedic effect, not really expecting the entire room to slap their foreheads and say, “Oh, now we get it! We’re anti-science, not them!” In the normal world, it’s called humor or sarcasm or satire.

I happen to have a longstanding online and email relationship with site’s proprietor and I know that IRL David is a real scientist. We just disagree a lot, that’s all.

Your influence on this crowd is dramatic and discourages innovative thinking.
A real scientist–instead of a dogmatic anti-science zealot–would want to keep exploring options and alternatives with an open mind.

#26 Jay Gordon

It’s good to find an ally in my occasionally illogical discussions with the anti-science crowd here.

@ Zach Miller:
” the uneducated have decided to rise up and declare that their voices and worldviews have just as much weight– if not MORE–than educated scientists.”

Sure. What’s alarming is that they do not seem to understand that people have *unequal* skills and knowledge- altho’ we would want all to have equal *rights* under the law -that doesn’t equate to equal voices in debate or equality in expertise. A few woos are talking about *political action* to even the score.

One of the idiots I survey speaks about the *cult* of the expert- and how the public “foolishly” seeks the opinion of oh, doctors and scientists who are *merely* the servants of blind orthodoxy and lock-step corporatist science.**

** oh crap, I’m becoming fluent in the perversion of the English language into altspeak. Time for a drink!

While I’m at it: AoA announces a new group blog- the ironically named “Thinking Moms’ Revolution”, which enables many to rhapsodies anti-scientifically as only AoA regulars can- featuring Alison MacNeil and L. Goes.
Don’t shoot me, I’m only the messenger.

@LW I’m not quite sure what you’re talking about but if you’re commenting on the the phraseÂ “”Your not a real scientist: You just play one on TV.” it’s a play on words on the oft-used comedic phrase: “I’m not a real doctor but I play one on TV.” The tone was somewhat jocular and an attempt at role reversal because everyone attacks the so-called anti-vax crowd as anti-science.

I had only quoted Dr. Gordon’s parting insult. I thought it was overkill (and would put me in moderation) if I quoted the whole comment. But now that Dr. Gordon has acknowledged authorship and claimed comment #20 was humorous, well, let’s take a look.Â

Why is it so hard for you to understand that a real scientist would support judicious use of all medications and medical interventions?

Not the same dose for everyone or the case same surgery for everyone or the same protocol for everyone.

Now, see, I was always told that humor needs to have a connection to reality. Given that Orac treats cancer and has to come up with individual treatment plans for each patient, this doesn’t come off as humorous; it simply appears bizarre and stupid.

Your influence on this crowd is dramatic and discourages innovative thinking.

Now, you know, this sounds strikingly like a slam at both Orac and his commenters. Â But Dr. Gordon says it is humor. Â And Dr. Gordon is an honourable man.

I do find this funny, but not, I think, the way that Dr. Gordon claims he intended. Â Authoritative pronouncements based in ignorance can be quite amusing. Â He clearly hasn’t read enough of the comments over the years. Â Some people who comment here are very creative.

A real scientist–instead of a dogmatic anti-science zealot–would want to keep exploring options and alternatives with an open mind.

Well, this is funny too. Â Dr. Gordon criticizing anyone for not exploring options and alternatives? Â Lack of insight can be very amusing.

Your not a real scientist: You just play one on TV.

Ha ha ha.

I think Dr. Gordon should give up his day job and seek fame and fortune as comedian.

C’mon, everyone. Where’s the science in giving the same dose of any medication to a 20 pound baby, a 45 pound five-year-old and an adult. For instance, the well-known triple live virus MMR vaccine?

Science involves open minds, discovery of new ideas, and much more. Your attitudes are anti-science.

Where’s the science you ask Dr. Jay? Well did you not take immunology in med school or was it too long ago or was the information just too inconvenient for your biases? Perhaps you could do with some continuing education if you have to come here to ask us. But to the point, have you considered a relatively naive immune system versus amnestic response and that some vaccines are dosed according to weight and age? Instead of “discovering new ideas” in your own very special way, how about discovering some basics.

Years ago I remember news reports were fairly common that a restaurant employee was found to be infected and people who had been to that particular establishment should get an immune globulin shot. One entire office area of a building I worked at had to get those shots because someone there came down with HepA, and they had been sharing a popcorn bowl. That doesn’t happen much anymore.

My son, who is now 19, was in first or second grade when there was an outbreak of Hep A. He got a shot – he remembers queuing with his classmates. My friend’s twins both caught it – one of them was hospitalized as he was very ill. Hep A is no joke. I agree, I haven’t seen much about Hep A outbreaks in years.

Hep A is no joke. I agree, I haven’t seen much about Hep A outbreaks in years.

Rock Island, Illinois, 2009. McDonald’s employee (32 confirmed cases, eventually). To really make it special, it happened the week the county had a brand new PIO, brand new EMA director, and the health department’s CD RN was on vacation.

I had a friend who went down with hepatitis A some years ago, before a vaccine was widely available. It didn’t seem like a mild disease from where I was sitting. It lasted for months and it was extremely inconvenient for her and those looking after her, as it is so contagious. As I recall all her bed linen and clothes had to be boil-washed, eating utensils autoclaved etc. When doctors refer to a disease as “mild” it generally means it is unlikely to be life-threatening, not that you can continue life as normal without missing a day’s work.

Incidentally, one interesting thing I remember was that she was an addicted tobacco smoker, and the first sign she was ill was that she lost all interest in smoking, before she was noticeably jaundiced and developed other symptoms. I always wondered if there was a fortune-making idea for smoking cessation in there somewhere. There must be a biochemical reason for that tobacco aversion.

I’m going to paraphrase a quote by Isaac Asimov here.
“Anti-intellectualism has been a persistent thread running through our national discourse for years, fuelled by the false idea that my ignorance is as good as your knowledge.”

@ Shay: I remember three very large outbreaks all associated with dirty food handlers in two popular restaurants and with a food prep person in a specialty delicatessen. We offered IG shots to all the patrons who could have possibly been exposed to these food handlers…thousands of doses of IG, that depleted our supply of IG rather quickly. We borrowed from neighboring counties and got IG from our State Health Department.

“One CD nurse on vacation?” I was one of 12 CD nurses along with two physicians in my department (much larger county).

“The science is settled” seems to be what provokes the AGW denialists the most.

With no exceptions that I’ve ever seen, they are driven by emotion and political ideology and don’t even know the extent or concepts of the science that is said to be settled.

I’ve repeatedly invited them to at least dispute, with evidence, the three foundational facts of AGW:

-Greenhouse gases exist, and CO2 is one of them
-Humans are creating more GHGs than would otherwise exist
-Global average temperatures are increasing

Absolutely 100% of the time, they fail to engage. It always turns into an emotive slushpuddle of how much they hate government and Al Gore. I have never, ever had anyone stand up straight and say “Yes, I dispute the heat-trapping properties of methane,” or “No, that submerged petroleum would have dug itself up and burned itself even if we weren’t here.” Often, they don’t seem to even grasp why I have brought up those three particular points in the first place.

The foundational science is settled, but the notion just repels them as surely and automatically and unthinkingly as the matching end of a magnet.

Jay Gordon: “Not the same dose for everyone or the case same surgery for everyone or the same protocol for everyone.”

And if physicians employ different doses and protocols for different patients, how are they determined? Dr. Jay would have us believe that one intuits this according to anecdotes and personal biases. That’s not what I learned in medical school, but Jay knows better.

Cynical Pediatrician: “From one FAAP to another, why do you actively promote yourself as a Fellow of the AAP when you have such disagreement with so many of that organization’s recommendations?”

This has been remarked on before. The likely answer is that Jay thinks appending “FAAP” to his name and degree lends him an air of expertise and respectability. The fact that the American Academy of Pediatrics stands up for the value of vaccination in stark contrast to his foolish and dangerous antivax beliefs doesn’t matter.